Insurance Corona Claim: If you are getting treatment in a hospital that is not part of your insurance company’s network, then you will have to pay money from your pocket and claim it later.
COVID Insurance Claim: You may have to travel to the hospital during Corona. Medical bills are also likely to increase. In such a situation, many of you will depend on health insurance for this expense. For this, you have to understand how medical expenses are claimed. For this, should the money be paid later from the insurance or is it paid directly from the insurance instead of paying the bill in the hospital? Let us tell you how a claim is made for health insurance.
Health insurance claims are in two ways –
- Cashless claim
Your chosen health insurance plan (Health Insurance) should have cashless facility for this. Often all health plans provide cashless facility in the hospital of their network. Therefore, it is important that before taking the policy, check whether you have the nearest hospital in that company’s network. Cashless means that you will not have to pay any amount in the hospital. For this, you have to fill the form. You may have to pay some advance amount during hospitalization and also have to provide KYC papers along with the policy number. Here the insurance company gives money directly and you do not have to reimburse the bill later.
Taking Policy Reimbursement
If you are getting treatment in a hospital that is not part of the network of your insurance policy company, then you will have to pay money from your pocket and later claim it from the insurance company. To do this (Reimbursement) claim, you have 7 to 15 days after discharge. After hospitalization, you should ensure that you have all the documents according to the claim form. Keep all the hospital expenses and prescriptions papers. These include the submission of claim form, discharge, prescription and other bills at the time of claim.
These documents will be required while making a claim to a health insurance company
- Claim form filled with complete and correct information
- Investigation Report
- All original bills and related documents.
- Medical certificate, case file etc.
- Discharge Card, Summary Report, Hospital Clearance Form
- FIR is also required in case of accident
Easy procedure and the family does not have any problem at the time of claim, so it is important that you fill all the information correctly while taking the insurance policy and definitely know about the claim process from the agent.
Finance Minister raised the issue
Arrive at the hospital for the treatment of corona on the hope of health insurance and if the hospital did not provide you cashless insurance despite having cashless insurance, then it is expected to be processed. Giving information, Finance Minister Nirmala Sitharaman has said that there are many such complaints in front of them where hospitals are refusing to give cashless insurance. On this issue, he has spoken to the insurance regulator IRDAI chairman SC Khuntia and asked to take action immediately. He said that Kovid was included in Comprehensive Health Insurance only in March 2020.
He said that cashless facilities are also available in networks and temporary hospitals.
In a tweet, the Finance Minister informed that as of April 20, 2021, insurance companies have given more than 9 lakh claims related to Kovid, which are around Rs 8,642 crore. He informed that tele-consultations are also covered in Cashless Insurance.
Sitharaman said that the insurance regulator would direct IRDAI companies to prioritize settlement and sanction in such Kovid cases.
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